"We haven't been very good at this," he said "We tend to look at kids as mini-adults, but they aren't the same."

"Often adolescents are trying to send a message (by abusing substances), but adults aren't listening," he went on. "We need to look at the whole picture, all aspects of the teen's life, or else we're spinning our wheels."

Both Poray and Herbst agree treatment is the key, but there is no cure for addiction. Lots of counseling, both one-on-one and group and family sessions, as well as support groups and mental health services, are needed to break the addictive behavior, they say.

"Treatment is much more complex that adult treatment," said Poray. "It's often the tip of the iceberg. Adolescent behavior often mirrors family issues."

The family must be involved, Herbst agreed.

"You have to be vigilant, to recognize why they abused to begin with," he said.

The family must be involved in the treatment, since kids often think they are the problem.

The Pennsylvania Medical Society recommends that all patients be careful with prescription medications, and they say parents should talk to their children about the dangers of taking meds without a prescription.

Since many people are on pain medications long-term, they may accumulate a large supply in their medicine cabinet. If a teenager pilfers a few, who will notice? Some pain medications, such as OxyContin and Percoset, can be sold on the street for as much as $40 per tablet.

"It's not uncommon to hear about patients or family members selling the pills to make a buck, especially in these hard times," said Dr. Adam Gordon of the PMS.

Poray said it's not just the kids from the wrong side of the tracks, either.

"Kids from good families get high to get noticed or accepted," he said. "They're under pressure to excel."

He has treated children as young as 8 or 9, he said, and some teenagers have been abusing for three years or more.